#IIEXHealth Recap: It’s All About the Patient

 

Editor’s Note: Last week almost 230 insights professionals focused on the healthcare industry convened in Philadelphia for the inaugural IIeX Health event. With multiple attendees from over 30 different Pharma, Biotech, Provider Networks, Insurers and other client-side organizations and many emerging technology companies as well as traditional research companies it was a “formulary for success” to create new thinking in healthcare research. Like all IIeX events the focus was on the nexus between client needs and partner offerings within the context of new technology, business models, and human understanding. All the feedback was fantastic and we were thrilled to be able to extend the success of the IIeX model into the field of healthcare research.

Andrew Jeavons was onsite at the event and generously provided his thoughts on the event for our readers. Whether you’re involved in healthcare research or not, this is compelling stuff: personal technology, consumer empowerment, and data proliferation are disrupting this category like everything else. As these trends accelerate (and they will) these shifts will have a profound impact us all as humans beings, not just as researchers.

 

By Andrew Jeavons

The IIEX Health conference took place on the 29^th of April at the WHYY center in Philadelphia. WHYY is the home to NPRs “Fresh Air” program and also some very high tech studios with what seemed like thousands of stage lights. Speakers from the pharmaceutical industry, software and research organizations were well represented making it a very fecund forum for ideas. From the outset patient centricity in the healthcare industry was established as a core theme. Lisa Courtade from Merck gave a powerful reminder that you have to listen to the patients when she told the story of the immunization push for people living in remote communities in Washington state. She also pointed that mobile is here and that we need get past the idea that innovation can be put off until tomorrow, it has to happen today. There is no choice.

The wearable revolution and the new impetus of personal data or the quantified self came under scrutiny from Stuart Karten of KARTEN:DESIGN. He presented a short but very impressive video showing how the use of the audio, rather than glass or watches, to interface to devices leads to a much better experience. No more glancing in strange directions or looking at a watch to find out someones’ name. He raised the idea that sensors, such as heart rate monitors, should be invisible if they are going to be accepted by the general population. These sensors linked to artificial intelligence then create a new approach to patient care. Again the key is patient not doctor centricity. This shift from doctors to patients as the source of information mirrors the rise of personal computing devises, smartphones are just the beginning of this. Garret Leahey from Google Life Sciences introduced us to “cyberchondria” as one one of the less desirable effects of medical diagnosis information being online. Yes it is clear that coupled with personal sensors and probably personal AI’s we are going to be able to take a much more agentic role in our healthcare. Fitbit is just the start of this. Garret quoted a projected 80% penetration of smartphones by 2018 as a core driver in this. Self diagnosis, with all its problems, is just a click away. I was particularly impressed with the contact lenses the Google X division has developed which will measure blood sugar for diabetics. This sort of real time health monitoring has to represent a vast improvement in preventative medicine and so cut the cost of healthcare. We can at least hope.

Peter Kinser from Universal Mind gave a great example of how technology can help in patient management in a very basic but important way. Patient compliance with drug regimes is critical, but for many patients it can be hard to do, not out of rejection of the treatment but from medical conditions they have that make compliance hard. Peter told us about Amy, a device which help patients get the correct drugs at the right time and can even adjust the regime according to diet because of drug interactions with foods. Amy helps so called polypharmic patients keep on track, from waking them up in the morning to presenting the correct drugs at the right time of the day. His talk also gave some interesting insights into the design challenges of such devices, the issue of how the door should open to allow the patient to get their medications was fascinating. The issues of UI and ergonomics were just as critical for this device as any other part of it. It also seems that personalizing with a name like Amy made it easier for patients to accept the device into their daily lives.

Amy shows that to make an impact on a patients’ life technology does not have to have very high aims. Drug regime compliance is not as dramatic as a new wonder drug, but it is critical important to many patients. Small wins over time, like improving drug regime compliance can be just as effective as a new wonder drug.

The approaches to researching patients are also evolving, it was striking that several speakers were appropriately vehement as emotion as a key driver of behavior. Kahneman’s System 1 and System 2 cognitive science framework for behavior is evidently becoming established as a core concept in the current research frameworks. System 1, the so called “emotional”, fast reaction system is most important as this is the basis for much of our behavior. The issue with emotions are measuring them, this takes new approaches.  Jeff Reynolds from Lieberman Research Worldwide spoke about overcoming the non-conscious and emotional barriers to medication regime adherence . He points out, correctly, that fMRI approaches are not scalable. His approach to this is multipronged, including reaction times to images, language analysis and “identification metrics”. Surveys can’t really capture this data effectively. The results showed that doctors who were more cheerful and with whom the patients could identify more with had patients who adhered to medication regimes better. Critically the length of time spent with the patient was not a factor, it seems that the quality and type of the interaction is more important.  Jeff also found that patients can identify more with brand name medications than generic ones.  David Forbes from Forbes Consulting also raised the flag for emotions as the core  insight , albeit the hardest one to access. His identification of the limbic system (where emotions are generated) as a “won’t say, can’t say” structure was particularly apposite. David actually gave a window for when emotional reaction affect reaction times to stimuli, he said that is was around 500 milliseconds.  At 800 milliseconds intellectual refection came into play. He was able to use this approach to tease out the core emotional needs for sufferers of enuresis. This came back to the need for a better relationship with their physician, with patients with this condition tending to feel scared of the doctor. There was a need in the patients to feel they were winning with this condition and to be empowered.  The idea that there is a time window in a reaction time where the emotional response can be gauged is very significant as reaction times tend to be seen as one dimensional.

An inevitable theme with any medical conference is regulation, mainly in the guise of the FDA. Dale Cooke from PhillyCooke Consulting gave a great overview of how the FDA is finally getting to grips with the web and social media as it affects the interactions between pharmaceutical companies and the general population. Until last year pharma companies have been very restricted in how they could use social media. One of the biggest changes is that pharma companies can use real time communications now, they can respond directly to social media postings relevant to their products. This opens up the stage for a lot more interaction between pharma companies and consumers in general.  The FDA have also clarified that user generated content is not the problem of the pharma companies, which seems logical. There does seem to have been quite shift in attitudes by the FDA regarding the web and social media, which is unusual.

In keeping with the theme of social media, a presentation by the crowd sourced medical diagnosis company CrowdMed gave some powerful examples of how the wisdom of the crowd, or as they term them “medical detectives”, can be used to diagnose rare disorders. The principle is pretty simple, data about your condition is uploaded to their system and then a group of medical detectives, who may not necessarily be medical doctors, work out along with the patient their diagnosis. This team approach is used in other institutions for diagnosis of rare conditions and CrowdMed seem to have developed a way of making it a far more accessible technique.  Two thirds of the medical detectives are doctors, others may be scientists or other health workers. The medical detectives come from 25 countries. CrowdMed seems to be a good example of harnessing crowd sourcing to make a meaningful difference in people’s lives.

The impressions I got from the conference was that there is a real desire for innovation in this community. One of the vendors was demonstrating a virtual reality system which I sadly did not get to try. The innovation is not only on the technical level though. The emphasis on emotion as a critical driver was indicative of a change in the models of consumers that are being used. Kahneman and his systems were spoken of many times as a fundamental guiding principle for researchers. Cognitive science is being brought into research in a big way, and I think this can only be a good thing. Hearing about reaction times as a tool for research is another sign that cognitive science is being brought into the tool kit of researchers. What was very clear was that a patient centric , rather than a physician centric approach is the new order. Power to the patient!